【作者】 赵文川； 韩晓晨； 张文超； 陈华； 赵聪； 许晨； 孙宝存；

【Author】 Zhao Wen-Chuan Department of Head & neck, Cancer Instittute & Hospital, Affiliated Tianjin Medical University, Tianjin 300060, P.R.China

【机构】 天津医科大学附属肿瘤医院头颈科；

【摘要】 目的:寻找No期甲状腺乳头状癌(PTC)颈淋巴结转移相关的分子标志物。方法:预防性颈清术治疗的75例 No期PTC(组织病理诊断为“癌侵出包膜”)组织标本行免疫组化染色检测其VEGF—C、c—Met、Cyclin D1和Ret、 HBME-1、CK19的表达,并结合其临床、病理及随访资料分析总结。结果:术后切除标本病理检查有淋巴结转移及10 年以上随访期内出现颈淋巴结转移均属于术后“N+”。结果N-40例,N+35例,其颈部淋巴结转移发生率为46． 7％。术后切除的外科标本中有淋巴结转移及随访期内发生颈淋巴结转移组cyclinD1表达明显高于术后外科切除标本中未发现转移淋巴结或随访期间未发生淋巴结转移组(N -)(P<0．05),而VEGF—C、c-Met的表达两组间无明显差异。术后外科切除标本中有淋巴结转移及随访期内发生颈淋巴结转移组与无转移组Ret表达有非常显著性差异(P< 0．01,而CK19,HBME-1的表达在两组间无明显差异。结论:有光镜下包膜侵出并有cyclin D1或Ret异常过表达的 N0期PTC病例须行预防性颈清术。更多还原

【Abstract】 Objective: Look for the biologic molecular markers related to the cervical lymphatic node metastasis of the papillary thyroid carcinoma( PTC ) at clinical No stage. Methods: The surgical specimen of 75cases of PTC at No stage which were diagnosed as "extracapsular invision" histopathologically treated surgically with the preventive neck dissection were studied immunohistochemically on the expressions of VEGF-C, Cyclin D1, c-Met and Ret, HBME-1, CK19. Analysis of the results combined with their clinical, pathological and folio wing-up informatiom were made. Results: In 35 cases of these 75 cases, the lymphatic node metastasis was found ( N+) in the post-operative specimen or during the following-up period for ten years, the incidence of the cervical node metastasis was 46.7%. The rates of the positive expression of CyclineDl and Ret in the N+ group was much higher than them in the N- group ( P<0.05)( p<0.01). No significant differences of the expression rates of VEGF-C, c-Met, CK19 and HBME-1 was found between the N-group and N+ group. Conclusion: If the thyroid tumor tissue of the patients with the No stage of PTC were diagnosed histopathologically as "extracapsular invision" and had the positive Clcyin Dl or Ret positive expression, the preventive neck dissection should be performed on these cases.更多还原